# Association between WeChat-based remote care guidance and diabetic foot ulcer healing: a retrospective cohort study

## TL;DR

Using WeChat for remote care improved healing of diabetic foot ulcers, especially for moderate cases and those needing procedures.

## Contribution

Demonstrates WeChat-based remote care improves healing rates and patient satisfaction in diabetic foot ulcers.

## Key findings

- WeChat guidance increased healing rates (88.1% vs 63.9%) and faster healing time compared to standard care.
- Greater quality of life and treatment satisfaction improvements observed in the WeChat group.
- Effect was strongest for Wagner grade 2–3 ulcers and patients receiving interventional procedures.

## Abstract

The aim of this study was to evaluate the effectiveness of WeChat-based remote care guidance as a supplement to standard care for patients with diabetic foot ulcers. Our specific objectives were to compare healing rates, self-management behaviors, and patient satisfaction between the two groups, with a focus on identifying patient subgroups that might benefit most from this approach.

A retrospective cohort study was conducted at Fujian Maternity and Child Health Hospital between June 2021 and December 2022, with follow-up until December 2024. Among 131 eligible patients with diabetic foot ulcers (Wagner grades 1–4), 59 received WeChat -based guidance (intervention) while 72 received standard care (control). Primary outcomes included wound healing rate and time-to-healing. Quality of life (WHOQOL-BREF) and treatment satisfaction (DTSQs) were assessed at baseline, 3, 6, 12, and 24 months. Analyses were adjusted for demographic characteristics, clinical parameters, and disease severity indicators.

The intervention group showed significantly higher healing rates (88.1% vs 63.9%, P = 0.001) and faster healing time (HR = 2.27, 95% CI [1.35–3.82], P = 0.002). The effect was particularly pronounced in Wagner grade 2–3 ulcers (HR = 14.3–34.2, P < 0.001) and patients receiving interventional procedures (HR = 3.4, 95% CI [1.8–6.3], P <0.001). At 24 months, the intervention group demonstrated greater improvements in quality of life (mean difference = 7.87, P < 0.001) and treatment satisfaction (mean difference = 6.70, P < 0.001).

WeChat-based remote care guidance was associated with better diabetic foot ulcer healing outcomes, particularly for moderate-severity ulcers and patients undergoing interventional procedures. Our findings also suggest associations between this approach and improvements in quality of life and treatment satisfaction.